Consumer Resolution

At Medavie Blue Cross, customer satisfaction is important, and it is our commitment to respond to concerns and complaints promptly, accurately and respectfully.

We strive to provide our members with a transparent approach to address their concerns and complaints, and will employ our best efforts to respond and resolve where possible. All complaints and personal information collected, whether written or oral, will be handled in a timely, professional and confidential manner. If members have any questions or concerns about our products, services or representatives, we want to make sure that these concerns are handled fairly and efficiently.

Medavie Blue Cross has a simple complaint resolution process:

Discuss your concern with the person or office that sold the product or provided the service. Many issues can be resolved by simply speaking with your advisor or a customer service representative. Customer Service Resources can be found at: medaviebc.ca/customer-service

For complaints dealing with the denial of a life or disability claim, please contact the case manager who handled your claim. They will guide you through the appeal process for denied claims.

If your concern isn‘t resolved to your satisfaction in step one, please ask to speak with a manager in that area.

If you remain unsatisfied with the manager’s response, you may ask to have your complaint escalated to the Medavie Complaint Officer for a further review.

Medavie Complaint Officer
C/O Medavie Blue Cross
644 Main St P.O. Box 220
Moncton, NB E1C 8L3

Fax: 506-867-4651
Online through ClearView Connects

What you can expect: Upon receipt of an escalated written complaint, your concerns will be acknowledged in writing by the Medavie Complaint Officer and an investigation into your concerns will begin.

The Complaint Investigation:

During our investigation we may:

Contact you to clarify information you have already provided
Contact you to request additional information in writing
Share your complaint and supporting documentation with the area against whom allegations have been directed
Request additional information from other parties involved
Provide you with updates throughout the complaint handling process
Advise you of our decision and any action we will be taking

Our response to you: Once the investigation has been completed, you will receive a written response explaining the reasons for the decision. This a called a Final Position Letter.

If you continue to remain dissatisfied after following the Company’s internal complaint handling process and wish to pursue your complaint, external recourse is available to you, through various consumer organizations:

Canadian Life and Health Insurance OmbudService.

The OmbudService for Life & Health Insurance (OLHI) deals with concerns about life and health insurance products and services that have not been resolved through the company’s dispute resolution process.

OLHI may take on your case if, after receiving our final response, you would like to pursue the matter further, or if you have not received our final response in 90 days.

After the OmbudService has completed their investigation, you will receive a written response with their findings. Medavie will consider any recommendations made by the OmbudService.

Canadian Life and Health Insurance
20 Adelaide St. East, Suite 802
P.O. Box 29 Toronto,
ON M5C 2T6

Toll free: 1-888-295-8112
Fax: 416-777-9750
Website: www.olhi.ca

In Quebec – The regulation of life insurance companies in Quebec is administered by the Autorité des marchés Financiers (AMF). If you remain dissatisfied with how your complaint has been handled or with the results of the process, you may ask that your file be transferred to the AMF. Following the transfer, the AMF will examine the file and, if deemed appropriate, may offer dispute resolution services.

The filing of a complaint with the AMF does not interrupt the prescriptive period for civil remedies.

You can reach the AMF by:
Toll-free 1-877-525-0337
Quebec City 418-525-0337
Montreal 514-395-0337

E-mail: [email protected]

Federal Consumer Provision Complaints

The Financial Consumer Agency of Canada (FCAC) oversees compliance with federal consumer protection requirements. These requirements include providing consumers with information on complaint handling procedures and on borrowing costs. If you have a complaint about a consumer provision, you may contact the FCAC at:

Financial Consumer Agency of Canada
6th floor, Enterprise Building
427 Laurier Avenue West
Ottawa, ON, K1R 1B9

For privacy related issues

In the course of providing customers with quality health, life and travel coverage, Medavie Blue Cross acquires and stores certain personal information about its clients and their dependents. Protecting personal information is not new to us. Ensuring the confidentiality of client information has always been fundamental to the way we do business, and our staff takes the privacy policies and procedures we have in place to ensure that confidentiality very seriously.

If you require further information on our privacy policy, please address your questions or concerns in writing to:

Chief Privacy Officer
Medavie Blue Cross
644 Main Street
PO Box 220
Moncton, NB E1C 8L3

E-mail: [email protected]

If your concern has not been addressed to your satisfaction, you may file a formal complaint with the Office of the Privacy Commissioner of Canada. The Privacy Commissioner oversees compliance with the Privacy Act, including personal information-handling practices and the Personal Information Protection and Electronic Documents Act (PIPEDA).

Office of the Privacy Commissioner of Canada
30 Victoria Street
Gatineau, Québec K1A 1H3

Toll-free: 1-800-282-1376
Phone: 819-994-5444
Fax: 819-994-5424

Website: www.priv.gc.ca